Elijah Wilder, D.O.
Individual provider Active NPI Psychiatry Physician · Temecula, CA
NPI 1083976971 · NPPES record last updated Sep 9, 2026
Key facts
- NPI
- 1083976971
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 02006180A (IN)
- Practice address
- 41877 Enterprise Cir N Ste 200
Temecula, CA 92590-5628 - Phone
- (909) 755-0585
- Fax
- (951) 228-9267
- NPI assigned
- Jun 15, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Philadelphia College of Osteopathic Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Activate CR, PLLC
Community Mental Health Center Inc.
Practice addresses (Care Compare)
13500 Ponder LN
Frisco, TX 75035-5974
Phone (214) 272-2774
285 Bielby Rd
Lawrenceburg, IN 47025-1055
Phone (812) 537-1302
6817 Southpoint Pkwy
Suite 203
Jacksonville, FL 32216-6286
Phone (214) 272-2774
Hospital & facility affiliations
- St Elizabeth Dearborn Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (6 enrollments) in OH, IN, KY, TN, TX, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170522002523 | OH | Practitioner - Psychiatry | 9133496193 | Reassigns benefits to 1 organization |
| I20201030001378 | IN | Practitioner - Psychiatry | 9133496193 | Reassigns benefits to 5 organizations |
| I20240828002021 | KY | Practitioner - Psychiatry |
9133496193 | |
| I20240905000375 | TN | Practitioner - Psychiatry | 9133496193 | |
| I20250207000336 | TX | Practitioner - Psychiatry | 9133496193 | Reassigns benefits to 1 organization |
| I20250227003724 | FL | Practitioner - Psychiatry | 9133496193 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02006180A | IN | MD | Psychiatry Physician |
| 34012700 | OH | MD | Psychiatry Physician |
Practice roles
Locations
6817 Southpoint Pkwy
Ste 203
Jacksonville, FL 32216
Phone (904) 256-9202
2620 Industrial Dr
Bedford, IN 47421
Phone (812) 583-6540
7230 Arbuckle Cmns
Ste 203
Brownsburg, IN 46112
Phone (317) 207-0273
821 N State Road 135
Greenwood, IN 46142
Phone (317) 560-4300
6330 Digital Way
Indianapolis, IN 46278
Phone (314) 473-6688
9240 N Meridian St
Ste 340
Indianapolis, IN 46260
Phone (317) 291-1967
285 Bielby Rd
Lawrenceburg, IN 47025
Phone (812) 537-1302
1101 Summit Rd
Cincinnati, OH 45237
Phone (513) 948-3600
30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930
1101 S Detroit Ave
Toledo, OH 43614
Phone (419) 381-3024
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 02006180A | IN | Yes |
| Psychiatry Physician | 2084P0800X | 20A22919 | CA | |
| Psychiatry Physician | 2084P0800X | 34012700 | OH | |
| Psychiatry Physician | 2084P0800X | 04444 | KY |
Addresses
Primary practice location
41877 Enterprise Cir N Ste 200
Temecula, CA 92590-5628
Mailing address
PO Box 636256
Central Credentialing ML 806
Cincinnati, OH 45263-6256
Phone (513) 585-5508
Other practice location 1
234 Goodman St
Cincinnati, OH 45219-2364
Phone (513) 558-7700
Other practice location 2
285 Bielby Rd
Lawrenceburg, IN 47025-1055
Phone (812) 537-1302
Other practice location 3
370 Cumberland Way
Madison, TN 37115-3170
Phone (770) 502-5030
Other practice location 4
3200 Burnet Ave
Cincinnati, OH 45229-3019
Phone (513) 558-7700
Other practice location 5
3130 Highland Ave
Cincinnati, OH 45219-2399
Phone (513) 584-8753
Other practice location 6
260 Stetson St
Cincinnati, OH 45219-2498
Phone (513) 558-7700
Other practice location 7
3131 Harvey Ave
Cincinnati, OH 45229-3000
Phone (513) 585-8227
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300047738 | Medicaid | IN | |
| 7100473760 | Medicaid | KY |
Other providers in Temecula, CA
- Whitson Family Therapy, Apc
- Rochelle M. Whitson
- Kenneth B Whitworth
- Anna Wiesemeyer
- Taylor Wikel
- Grace Jerelyn Wiles
- Laura Marie Wiles
- Ryezeir Wilkins
- Karli Will
- Kara Jean Willbanks
All providers in Temecula, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.